徳島大学 / 教育研究者総覧 --- 石原学

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1.	兼松康久, 山口泉, 石原学, 曽我部周, 宮本健志, 高麗雅章, 島田健司, 黒田一駿, 山本雄貴, 山本伸昭, 和泉唯信, 髙木康志 : 循環器病を防ぐために徳島県循環器病推進計画の中での急性期脳卒中診療の取り組み, 四国医学雑誌, Vol.78, No.5-6, 135-138, 2022年. (要約) Cerebrovascular and cardiovascular disease are the main causes of death in Japan. The leading causes of the need for long-term care in Japan are also cerebrovascular and cardiovascular disease, which together account for more than one-fourth of the total. The Cerebrovascular and Cardiovascular Disease Control Act, of Japanese national law, was promulgated by a legislative act in 2018. On the basis of the Cerebrovascular and Cardiovascular Disease Control Act, the Ministry of Health, Labour and Welfare, Japan, published the Japanese National Plan for Promotion of Measures Against Cerebrovascular and Cardiovascular Disease (Japanese National Plan) in 2020. By the example of the Japanese National Plan, Tokushima prefecture established a cerebrovascular and cardiovascular disease countermeasure promotion plan to progress cerebrovascular and cardiovascular disease measures according to their own circumstances. One of the important measures of the plan is improving emergency transportation systems. Patients with intracranial large vessel occlusion strokes should be served by direct transfer to endovascular capable centers avoiding delays by misguided transfer to primary stroke centers. Considering the limited availability of endovascular capable centers, accurate identification of patients with high probability of having large vessel occlusion strokes in the prehospital setting is importance. To address this problem, we introduced prehospital scale called Field Assessment Stroke Triage for Emergency Destination (FAST-ED) on emergency transportation systems in Tokushima city. (キーワード) Cerebrovascular and cardiovascular disease / emergency transportation systems / prehospital scale (文献検索サイトへのリンク) ● CiNii @ 国立情報学研究所 (CRID): 1050295181679880704 (CiNii: 1050295181679880704)
2.	中野勇希, 佐藤功志, 佐藤裕紀, 百田和貴, 秋本雄祐, 布村俊幸, 新井悠太, 石原学, 上野義豊, 田根なつ紀, 板垣大雅, 大藤純 : 経肺圧を指標としたPEEP設定により，致死的低酸素血症から改善した神経芽細胞種に伴う腹部コンパートメント症候群の一乳児症例, 四国医学雑誌, Vol.2022;78, No.3,4, 115-120, 2022年. (要約) Background : Neuroblastoma is the most common extracranial solid tumor of childhood. Although the prognosis of neuroblastoma is relatively good, newborns less than two months of age with stage 4S neuroblastoma may present with aggressive hypoxia and restrictive respiratory impairment due to abdominal compartment syndrome. Case presentation : Two-month-old girl, height of 63 cm and body weight of 10 kg. She was diagnosed as neuroblastoma with Stage 4S. Because she was suffered from refractory hypoxemia and restrictive respiratory impairment due to abdominal compartment syndrome induced by multiple liver metastasis and massive ascites, she was transferred to our ICU. Her trachea was intubated and ventilated with assist/controlled mode, driving pressure 22 cmH2O, positive end-expiratory pressure(PEEP)8 cmH2O, fraction of inspiratory oxygen(FIO2)1.0, but tidal volume was obtained only 3.2 mL/kg and PaO2/FIO2 ratio of 55 mmHg. Therefore, we insert esophageal sensor and monitored esophageal pressure to performed transpulmonary pressure guided PEEP titration. When we changed PEEP from 8 to 15 cmH2O so that the end-expiratory transpulmonary pressure achieving 0 to 5 cmH2O, her oxygenation(PaO2/FIO2 ratio : 55 to 178 mmHg)and respiratory compliance(1.4 to 3.0 mL/cmH2O)were dramatically improved. Her respiratory condition was further stabilized by ascites puncture and radiotherapy, and the patient was extubated successfully on the 25th ICU day. Conclusions : Although pediatric neuroblastoma with stage 4S may induce severe respiratory efficiency, the responsiveness of treatment for neuroblastoma is promising. Multimodal treatments including optimal ventilator management such as transpulmonary pressure -guided PEEP titration contributes to improved patient's prognosis. (キーワード) Neuroblastoma / Abdominal compartment syndrome / Transpulmonary pressure (文献検索サイトへのリンク) ● CiNii @ 国立情報学研究所 (CRID): 1050575882547923200 (CiNii: 1050575882547923200)
3.	Taiga Itagaki, Yusuke Akimoto, Yuki Nakano, Yoshitoyo Ueno, Manabu Ishihara, Natsuki Tane, Yumiko Tsunano and Jun Oto : Relationships between double cycling and inspiratory effort with diaphragm thickness during the early phase of mechanical ventilation: A prospective observational study., PLoS ONE, Vol.17, No.8, 2022. (要約) Double cycling on the third day of mechanical ventilation was associated with strong inspiratory efforts and, possibly, changes in diaphragm thickness. (キーワード) 成人 (adult) / Aged / Diaphragm / Humans / Positive-Pressure Respiration / Respiration, Artificial / Retrospective Studies / Ventilators, Mechanical (出版サイトへのリンク) ● Publication site (DOI): 10.1371/journal.pone.0273173 (文献検索サイトへのリンク) ● PubMed @ National Institutes of Health, US National Library of Medicine (PMID): 35976965 ● Search Scopus @ Elsevier (PMID): 35976965 ● Search Scopus @ Elsevier (DOI): 10.1371/journal.pone.0273173 (DOI: 10.1371/journal.pone.0273173, PubMed: 35976965)
4.	Yoshitoyo Ueno, Saki Harada, Koji Sato, Kazuki Momota, Hiroki Sato, Yusuke Akimoto, Yuta Arai, Toshiyuki Nunomura, Manabu Ishihara, Natsuki Tane, Taiga Itagaki, Yasuhiko Nishioka and Jun Oto : Independent lung ventilation for the management of acute allograft rejection after single-lung transplantation for end-stage emphysema., The Journal of Medical Investigation : JMI, Vol.69, No.3.4, 323-327, 2022. (要約) Background : We herein report the use of independent lung ventilation (ILV) for managing acute allograft rejection after single-lung transplantation (SLT) for end-stage emphysema. Case presentation : A 54-year-old woman was transferred to our hospital with severe hypoxemia and respiratory distress due to unilateral lung disease with diffuse alveolar damage in the right donor lung associated with acute allograft rejection and with hyperinflation of the left native lung due to emphysema. She was unresponsive to immunosuppressive medications and conventional ventilation strategies, so different ventilator settings for each lung were required. A double-lumen endotracheal tube (DLT) was inserted, and ILV was initiated. The right lung was ventilated with high positive end-expiratory pressure (PEEP), intended for lung recruitment, and the left lung was ventilated with lung protective strategies using a low tidal volume and low levels of PEEP to avoid hyperinflation. Two days later, her lung function was dramatically improved, and the DLT was replaced with a single-lumen endotracheal tube. Gas exchange was maintained, and she was successfully weaned from mechanical ventilation on intensive-care unit day 15. Conclusions : ILV appears to be effective and safe for managing acute allograft rejection after SLT for emphysema. J. Med. Invest. 69 : 323-327, August, 2022. (キーワード) Allografts / Emphysema / Female / Humans / Lung / Lung Transplantation / Middle Aged / Pulmonary Emphysema / Respiration, Artificial (出版サイトへのリンク) ● Publication site (DOI): 10.2152/jmi.69.323 (文献検索サイトへのリンク) ● PubMed @ National Institutes of Health, US National Library of Medicine (PMID): 36244790 ● Search Scopus @ Elsevier (PMID): 36244790 ● Search Scopus @ Elsevier (DOI): 10.2152/jmi.69.323 (DOI: 10.2152/jmi.69.323, PubMed: 36244790)
5.	Izumi Yamaguchi, Yasuhisa Kanematsu, Kenji Shimada, Nobuaki Yamamoto, Kazuhisa Miyake, Takeshi Miyamoto, Shu Sogabe, Eiji Shikata, Manabu Ishihara, 山本陽子, Kazutaka Kuroda and Yasushi Takagi : Single-session hematoma removal and transcortical venous approach for coil embolization of an isolated transverse-sigmoid sinus dural arteriovenous fistula in a hybrid operating room: illustrative case, Journal of Neurosurgery. Case Lessons, Vol.3, No.21, CASE2267, 2022. (要約) Dural arteriovenous fistula (DAVF) can present with massive hematoma, which sometimes requires emergent removal. Therefore, a surgical strategy for single-session hematoma removal and shunt occlusion in the same surgical field is important. A 73-year-old man was transferred to the authors' hospital with a headache. Brain computed tomography (CT) revealed an intracerebral hematoma in the right temporoparietal lobe (hematoma volume 12 ml). A cerebral angiogram revealed a right isolated transverse-sigmoid sinus (TSS)-DAVF fed by the occipital artery and middle meningeal artery. There was cortical venous reflux into the Labbé vein and posterior parietal vein. Percutaneous transarterial and transvenous embolization were unsuccessful. The following day, his consciousness level acutely declined with a headache, and brain CT showed hematoma expansion (hematoma volume 41 ml) with a midline shift. Therefore, the authors performed single-session hematoma removal and a transcortical venous approach for coil embolization of an isolated TSS-DAVF in a hybrid operating room. His postoperative course was uneventful. No recurrence was observed 3 months postoperatively on cerebral angiography. Single-session hematoma removal and a transcortical venous approach for coil embolization of an isolated TSS-DAVF is considered in cases with massive hematoma. This strategy is useful, considering recent developments in hybrid operating rooms. (出版サイトへのリンク) ● Publication site (DOI): 10.3171/CASE2267 (文献検索サイトへのリンク) ● PubMed @ National Institutes of Health, US National Library of Medicine (PMID): 35734231 ● Summary page in Scopus @ Elsevier: 2-s2.0-85160834258 (DOI: 10.3171/CASE2267, PubMed: 35734231, Elsevier: Scopus)
6.	Yuki Yamamoto, Nobuaki Yamamoto, Yasuhisa Kanematsu, Izumi Yamaguchi, Manabu Ishihara, Takeshi Miyamoto, Shu Sogabe, Kenji Shimada, Yasushi Takagi and Yuishin Izumi : The claw sign predicts first-pass effect in mechanical thrombectomy for cerebral large vessel occlusion in the anterior circulation, Surgical Neurology International, Vol.13, No.72, 1-7, 2022. (要約) Mechanical thrombectomy (MT) is an effective treatment for acute cerebral large vessel occlusion (LVO). Complete recanalization of vessels in a single procedure is defined as the first-pass effect (FPE) and is associated with good prognosis. In this study, angiographic clot protruding sign termed the "claw sign," was examined as candidate preoperative imaging factor for predicting the FPE. We retrospectively analyzed data from 91 consecutive patients treated for acute LVO in the anterior circulation by MT between January 2014 and December 2019. The claw sign was defined as a thrombus that protruded proximally by more than half of the diameter of the parent artery. Radiological findings such as claw sign, clinical and etiological features, and outcomes were compared between groups with and without successful FPE. Multivariate analysis was conducted to evaluate perioperative factors associated with FPE. FPE was achieved in 26 of 91 (28.6%) patients and the claw sign was observed in 34 of 91 (37.4%) patients. The claw sign was significantly more frequent in the successful FPE group than in the failed FPE group (53.8% vs. 30.8%; = 0.040). After the multivariate analysis, the claw sign was the only pretreatment parameter that could predict FPE (odds ratio, 2.67; 95% confidence interval, 1.01-7.06; = 0.047). The claw sign is an angiographic imaging factor that might predict FPE after MT for anterior circulation acute ischemic stroke. (徳島大学機関リポジトリ) ● Metadata: 117192 (出版サイトへのリンク) ● Publication site (DOI): 10.25259/SNI_1160_2021 (文献検索サイトへのリンク) ● PubMed @ National Institutes of Health, US National Library of Medicine (PMID): 35242438 ● Search Scopus @ Elsevier (PMID): 35242438 ● Search Scopus @ Elsevier (DOI): 10.25259/SNI_1160_2021 (徳島大学機関リポジトリ: 117192, DOI: 10.25259/SNI_1160_2021, PubMed: 35242438)
7.	Yusuke Akimoto, Natsuki Bando, Hiroki Sato, Koji Sato, Kazuki Momota, Toshiyuki Nunomura, Yoshitoyo Ueno, Manabu Ishihara, Natsuki Tane, Taiga Itagaki and Jun Oto : Acquired laryngomalacia as a cause of post-extubation respiratory failure in patient with postoperative seizure and central pontine myelinolysis after craniotomy., The Journal of Medical Investigation : JMI, Vol.69, No.3.4, 316-319, 2022. (要約) Background : Laryngomalacia is a congenital abnormality of the larynx that commonly occurs in children and rarely in adults. We report the first case of acquired laryngomalacia mainly due to postoperative seizure and central pontine myelinolysis after scheduled craniotomy. Case presentation : A 69-year-old man was admitted to the hospital for elective craniotomy for craniopharyngioma. After the surgery, he developed refractory seizure and required intubation and mechanical ventilation in the intensive-care unit (ICU). After treatment for the seizure, he was extubated. However, immediately after extubation, he developed stridor and respiratory retraction. We performed fiberoptic laryngoscopy and confirmed that the epiglottis had collapsed into the posterior wall of the pharynx during inspiration, which was suspected to be laryngomalacia. He received invasive mechanical ventilation for two days following re-extubation. After the second extubation, he developed stridor again due to acquired laryngomalacia. Six days later, his respiratory condition had worsened, and he received re-intubation and tracheostomy. After ICU discharge, central pontine myelinolysis was diagnosed by magnetic resonance imaging. Conclusions : Adult-onset laryngomalacia is a rare cause of upper airway obstruction but should be considered as a cause of postoperative extubation failure. We should not delay performing fiberoptic laryngoscopy to evaluate this pathology and provide optimal treatment. J. Med. Invest. 69 : 316-319, August, 2022. (キーワード) Aged / Airway Extubation / Child / Craniotomy / Humans / Laryngomalacia / Laryngoscopy / Male / Myelinolysis, Central Pontine / Respiratory Insufficiency / Respiratory Sounds / Seizures (出版サイトへのリンク) ● Publication site (DOI): 10.2152/jmi.69.316 (文献検索サイトへのリンク) ● PubMed @ National Institutes of Health, US National Library of Medicine (PMID): 36244788 ● Search Scopus @ Elsevier (PMID): 36244788 ● Search Scopus @ Elsevier (DOI): 10.2152/jmi.69.316 (DOI: 10.2152/jmi.69.316, PubMed: 36244788)
8.	Izumi Yamaguchi, Yasuhisa Kanematsu, Yoshifumi Mizobuchi, Yoshiteru Tada, Takeshi Miyamoto, Shu Sogabe, Manabu Ishihara, Hiroshi Kagusa, Yoko Yamamoto, Taku Matsuda, Keiko T. Kitazato, Yoshihiro Okayama and Yasushi Takagi : Chronic subdural hematoma associated with dural metastasis leads to early recurrence and death: A single-institute, retrospective cohort study, Journal of Clinical Neuroscience, Vol.94, 244-249, 2021. (出版サイトへのリンク) ● Publication site (DOI): 10.1016/j.jocn.2021.10.037 (文献検索サイトへのリンク) ● Search Scopus @ Elsevier (DOI): 10.1016/j.jocn.2021.10.037 (DOI: 10.1016/j.jocn.2021.10.037)
9.	Kenji Shimada, Izumi Yamaguchi, Manabu Ishihara, Takeshi Miyamoto, Shu Sogabe, Kazuhisa Miyake, Yoshiteru Tada, 北里慶子, Yasuhisa Kanematsu and Yasushi Takagi : Involvement of Neutrophil Extracellular Traps in Cerebral Arteriovenous Malformations, World Neurosurgery, E1-E7, 2021. (要約) Cerebral arteriovenous malformations (cAVMs) represent tangles of abnormal vasculature without intervening capillaries. High-pressure vascular channels due to abnormal arterial and venous shunts can lead to rupture. Multiple pathways are involved in the pathobiology of cAVMs including inflammation and genetic factors such as KRAS mutations. Neutrophil release of nuclear chromatin, known as neutrophil extracellular traps (NETs), plays a multifunctional role in infection, inflammation, thrombosis, intracranial aneurysms, and tumor progression. However, the relationship between NETs and the pathobiology of cAVMs remains unknown. We tested whether NETs play a role in the pathobiology of cAVMs. We analyzed samples from patients who had undergone surgery for cAVM and immunohistochemically investigated expression of citrullinated histone H3 (CitH3) as a marker of NETs. CitH3 expression was compared among samples from cAVM patients, epilepsy patients, and normal human brain tissue. Expressions of thrombotic and inflammatory markers were also examined immunohistochemically in samples from cAVM patients. Expression of CitH3 derived from neutrophils was observed intravascularly in all cAVM samples but not other samples. Nidi of AVMs showed migration of many Iba-I-positive cells adjacent to the endothelium and endothelial COX2 expression, accompanied by expression of IL-6 and IL-8 in the endothelium and intravascular neutrophils. Unexpectedly, expression of CitH3 was not necessarily localized to the vascular wall and thrombus. Our results offer the first evidence of intravascular expression of NETs, which might be associated with vascular inflammation in cAVMs. (徳島大学機関リポジトリ) ● Metadata: 116871 (出版サイトへのリンク) ● Publication site (DOI): 10.1016/j.wneu.2021.08.118 (文献検索サイトへのリンク) ● PubMed @ National Institutes of Health, US National Library of Medicine (PMID): 34478890 ● Summary page in Scopus @ Elsevier: 2-s2.0-85115331132 (徳島大学機関リポジトリ: 116871, DOI: 10.1016/j.wneu.2021.08.118, PubMed: 34478890, Elsevier: Scopus)
10.	Manabu Ishihara, Nobuto Nakanishi, Rie Tsutsumi, Kanako Hara, Kyoka Machida, Nobuaki Yamamoto, Yasuhisa Kanematsu, Hiroshi Sakaue, Jun Oto and Yasushi Takagi : Elevated Urinary Titin and its Associated Clinical Outcomes after Acute Stroke., Journal of Stroke & Cerebrovascular Diseases, Vol.30, No.3, 2021. (要約) Forty-one patients were included (29 male; age, 68 ± 15 years), 29 had ischemic stroke, 8 had intracerebral hemorrhage, and 4 had subarachnoid hemorrhage. The levels of urinary titin on days 1, 3, 5, and 7 were 9.9 (4.7-21.1), 16.2 (8.6-22.0), 8.9 (4.8-15.2), and 8.7 (3.6-16.2) pmol/mg Cr, respectively. The peak urinary titin level was associated with the mRS score (r = 0.55, p < 0.01), the NIHSS score (r = 0.72, p < 0.01), and the BI (r = -0.59, p < 0.01) upon hospital discharge. In multivariate analysis, the peak urinary titin was associated with poor outcome (p = 0.03). (キーワード) Aged / Aged, 80 and over / Biomarkers / Connectin / Disability Evaluation / Female / Functional Status / Humans / Male / Middle Aged / Patient Discharge / Predictive Value of Tests / Prospective Studies / Recovery of Function / Stroke / Time Factors / Treatment Outcome / Up-Regulation / Urinalysis (出版サイトへのリンク) ● Publication site (DOI): 10.1016/j.jstrokecerebrovasdis.2020.105561 (文献検索サイトへのリンク) ● PubMed @ National Institutes of Health, US National Library of Medicine (PMID): 33360523 ● Search Scopus @ Elsevier (PMID): 33360523 ● Search Scopus @ Elsevier (DOI): 10.1016/j.jstrokecerebrovasdis.2020.105561 (DOI: 10.1016/j.jstrokecerebrovasdis.2020.105561, PubMed: 33360523)
11.	Izumi Yamaguchi, Yasuhisa Kanematsu, Kenji Shimada, Kohhei Nakajima, Takeshi Miyamoto, Shu Sogabe, Eiji Shikata, Manabu Ishihara, Mai Azumi, Ayato Kageyama and Yasushi Takagi : Gelatinthrombin Hemostatic Matrix-related Cyst Formation after Cerebral Hematoma Evacuation: A Report of Two Cases, NMC Case Report Journal, Vol.8, No.1, 719-725, 2021. (出版サイトへのリンク) ● Publication site (DOI): 10.2176/nmccrj.cr.2021-0130 (文献検索サイトへのリンク) ● Search Scopus @ Elsevier (DOI): 10.2176/nmccrj.cr.2021-0130 (DOI: 10.2176/nmccrj.cr.2021-0130)
12.	Nobuto Nakanishi, Yasuhiro Suzuki, Manabu Ishihara, Yoshitoyo Ueno, Natsuki Tane, Yumiko Tsunano, Taiga Itagaki and Jun Oto : Effect of High-Flow Nasal Cannula on Sleep-disordered Breathing and Sleep Quality in Patients With Acute Stroke., Curēus, Vol.12, No.7, 2020. (要約) Introduction Sleep-disordered breathing (SDB) is common after stroke. Although the standard treatment of SDB is continuous positive airway pressure (CPAP) ventilation, the patient's intolerance and discomfort result in low adherence rates. Alternatively, high-flow nasal cannula (HFNC) may be useful as it reduces upper airway collapse with low level of positive pressure and well tolerability. The aim of this study was to investigate whether HFNC therapy reduces SDB and improves sleep quality with higher compliance rate. Methods We included acute stroke patients with SDB for the assessment of apnea-hypopnea index (AHI) >5/h using WatchPAT 200 (Itamar Medical Ltd, Caesarea, Israel). Patients who met inclusion criteria received HFNC therapy (40 L/min) with monitoring by WatchPAT. AHI, oxygen desaturation index (ODI), sleep efficiency, and rapid eye movement (REM) sleep were compared in patients with and without HFNC therapy. We also evaluated the patient's comfort of HFNC therapy (discomfort or not). Results Among 17 patients assessed for AHI, 12 received HFNC therapy. HFNC therapy was not adhered in two patients due to intolerance. Eight patients remained for final analysis. There were no differences in SDB and sleep quality with and without HFNC therapy as follows: HFNC therapy vs control; AHI 24.9 ± 20.1 vs 21.3 ± 15.0/h (p = 0.63), ODI 16.2 ± 16.5 vs 12.9 ± 12.3/h (p = 0.54), sleep efficiency 80.4 ± 12.9 vs 87.1 ± 6.2 (p = 0.28), percentage of REM sleep 19.4% ± 9.6% vs 27.6% ± 8.9% (p = 0.07). Two patients (17%) complained of discomfort among eight patients. Conclusion HFNC therapy did not improve SDB and sleep quality. Nonadherence and discomfort were observed in HFNC therapy. We need a large trial to confirm this result. (出版サイトへのリンク) ● Publication site (DOI): 10.7759/cureus.9303 (文献検索サイトへのリンク) ● PubMed @ National Institutes of Health, US National Library of Medicine (PMID): 32832300 ● Search Scopus @ Elsevier (PMID): 32832300 ● Search Scopus @ Elsevier (DOI): 10.7759/cureus.9303 (DOI: 10.7759/cureus.9303, PubMed: 32832300)
13.	秋本雄祐, 上野義豊, 髙島拓也, 石原学, 中西信人, 田根なつ紀, 綱野祐美子, 板垣大雅, 大藤純 : 側弯矯正固定術後の急性換気不全に対し気管支鏡による選択的気管支拡張術が奏功した1例, 日本集中治療医学会第4回中国・四国支部学術集会, 2020年.
14.	秋本雄祐, 上野義豊, 髙島拓也, 中西信人, 田根なつ紀, 綱野祐美子, 石原学, 板垣大雅, 大藤純 : 当院ICUにおけるカルバペネム系抗菌薬の使用状況とde-escalationに関する検討．, 第47回日本集中治療医学会学術集会, 2020年.
15.	髙島拓也, 上野義豊, 石原学, 中西信人, 田根なつ紀, 綱野祐美子, 板垣大雅, 大藤純 : 目標換気量の表示が人工呼吸患者の低一回換気量/肺保護換気の順守率に与える影響．, 第47回日本集中治療医学会学術集会, 2020年.
16.	Nobuaki Yamamoto, Yuki Yamamoto, Izumi Yamaguchi, Manabu Ishihara, Takeshi Miyamoto, Masaaki Korai, Kenji Shimada, Yasuhisa Kanematsu, Yuishin Izumi and Yasushi Takagi : Cone beam-computed tomography angiography by intravenous contrast injection is reliable to evaluate patients with large vessel occlusion, Journal of Clinical Neuroscience, Vol.70, 67-71, 2019. (要約) Mechanical thrombectomy (MT) for acute ischemic stroke (AIS) patients due to emergent large vessel occlusion (ELVO) is standard treatment, the benefits, however, are highly time-sensitive. After patient eligibility for reperfusion therapy is determined by conventional radiological examinations, the time to be transferred from the department of radiological examination to angiography-suites is critical. We speculated that the time required for the diagnosis of AIS might be reduced if we could determine MT eligibility in patients with ELVO at angiography-suites. Modern angiography-suites with flat panel detectors can perform cone beam (CB)-CT. We performed CB-CTA using intravenous injection of contrast agent to evaluate occlusion sites, collateral score, and construction of vessels distal to occlusion sites and determined if CB-CTA could be useful to evaluate patients with ELVO. We included 15 patients with ELVO diagnosed by conventional MRI or CT/CTA, and investigated whether CB-CTA was reliable to diagnose occlusion sites. We also studied if collateral score on CB-CTA was associated with prognosis after successful reperfusion by MT by comparison between favorable (modified Rankin scale (mRS) 0-2), and unfavorable outcome group (mRS 3-6). There was strong agreement of occlusion sites between CB-CTA and conventional radiological examination (κ = 0.80). Collateral score determined by CB-CTA was significantly different between favorable outcome and unfavorable outcome group (median collateral score 2.3 v.s. 1.3, p = 0.040). Although prospective study of AIS patients at a radiography department is indispensable, CB-CTA performed in an angiography-suite might be useful to evaluate patients with ELVO. (キーワード) Aged / Aged, 80 and over / Brain Ischemia / Carotid Artery Thrombosis / Computed Tomography Angiography / Contrast Media / Female / Humans / Infarction, Middle Cerebral Artery / Injections, Intravenous / Male / Middle Aged / Prognosis / Reperfusion / Retrospective Studies / Thrombectomy / Treatment Outcome (出版サイトへのリンク) ● Publication site (DOI): 10.1016/j.jocn.2019.08.078 (文献検索サイトへのリンク) ● PubMed @ National Institutes of Health, US National Library of Medicine (PMID): 31445814 ● Summary page in Scopus @ Elsevier: 2-s2.0-85070874852 (DOI: 10.1016/j.jocn.2019.08.078, PubMed: 31445814, Elsevier: Scopus)
17.	髙島拓也, 上野義豊, 石原学, 田根なつ紀, 中西信人, 綱野祐美子, 板垣大雅, 大藤純 : 高度肥満患者でのElectrical Impedance Tomographyと経肺圧を用いた適正PEEPの検討．, 第47回日本救急医学会総会, 2019年.
18.	田根なつ紀, 石原学, 髙島拓也, 上野義豊, 中西信人, 綱野祐美子, 板垣大雅, 大藤純 : 当院脳卒中センターにおける急性脳主幹動脈閉塞症例での病院前皮質症状評価の検討．, 第47回日本救急医学会総会, 2019年.

学術論文(紀要・その他):

1.	Izumi Yamaguchi, Yasuhisa Kanematsu, Kenji Shimada, Nobuaki Yamamoto, Masaaki Korai, Kazuhisa Miyake, Takeshi Miyamoto, Shu Sogabe, Eiji Shikata, Manabu Ishihara, Yuki Yamamoto, Kazutaka KURODA and Yasushi Takagi : Evaluation of Serial Intra-Arterial Indocyanine Green Videoangiography in the Surgical Treatment of Cranial and Craniocervical Junction Arteriovenous Fistulae: A Case Series, Operative Neurosurgery, Vol.25, No.3, 292-300, 2023. (要約) Intravenous indocyanine green (IV-ICG) videoangiography is commonly performed to detect blood flow in the microscopic view. However, intra-arterial ICG (IA-ICG) videoangiography provides high-contrast imaging, repeatability within a short period of time, and clear-cut separation of the arterial and venous phases compared with IV-ICG. These features are useful for detecting retrograde venous drainage (RVD) and shunt occlusion in arteriovenous fistulae (AVF) surgery. This study aimed to investigate whether IA-ICG videoangiography can be repeatable within a short period of time and be useful for detecting RVD and shunt occlusion in cranial- and craniocervical junction (CCJ)-AVF surgery. Between January 2012 and December 2022, 50 patients were treated with endovascular or surgical intervention for cranial- and CCJ-AVF at Tokushima University Hospital. Of these, 5 patients (6 lesions) underwent open surgery with IA-ICG videoangiography in a hybrid operating room. We analyzed the data of these 5 patients (6 lesions). There were 4/patient (median, range 2-12) and 3.5/lesion (median, range 2-10) intraoperative IA-ICG runs. IA-ICG videoangiography detected RVD in all patients. Clearance of IA-ICG-induced fluorescence was achieved within 30 seconds in all patients at each region of interest. After the disconnection of the fistulae, IA-ICG videoangiography and intraoperative digital subtraction angiography (DSA) confirmed the disappearance of RVD in all patients. There were no complications associated with IA-ICG videoangiography. This study showed that IA-ICG videoangiography is repeatable within a short period of time before and after obliteration and can be useful for detecting RVD and shunt occlusion in cranial- and CCJ-AVF surgery. IA-ICG videoangiography also allows intraoperative DSA studies in a hybrid operating room. Considering the recent advancements in hybrid operating rooms, combining IA-ICG videoangiography with intraoperative DSA is a useful strategy for cranial- and CCJ-AVF surgery. (キーワード) Humans / Indocyanine Green / Coloring Agents / Neurosurgical Procedures / Vascular Surgical Procedures / Arteries (出版サイトへのリンク) ● Publication site (DOI): 10.1227/ons.0000000000000796 (文献検索サイトへのリンク) ● PubMed @ National Institutes of Health, US National Library of Medicine (PMID): 37345942 ● Summary page in Scopus @ Elsevier: 2-s2.0-85168222953 (DOI: 10.1227/ons.0000000000000796, PubMed: 37345942, Elsevier: Scopus)

国際会議:

1.	Harumi Kadota, Shoma Fujisawa, Masaki Oono, Ryoma Morigaki, Nobuaki Yamamoto, Yasuhisa Kanematsu, Manabu Ishihara and Masami Shishibori : Development of a 3D visualization system for the cerebral aneurysm coil embolization, Proceedings Volume 11794, Fifteenth International Conference on Quality Control by Artificial Vision; 117940C (2021), Tokushima, Jul. 2021. (出版サイトへのリンク) ● Publication site (DOI): 10.1117/12.2589084 (文献検索サイトへのリンク) ● Search Scopus @ Elsevier (DOI): 10.1117/12.2589084 (DOI: 10.1117/12.2589084)

国内講演発表:

1.	兼松康久, 羽星辰哉, 山口泉, 石原学, 曽我部周, 高麗雅章, 島田健司, 黒田一駿, 山本伸昭, 髙木康志 : ICT, 2023年11月.
2.	高麗雅章, 兼松康久, 島田健司, 山本伸昭, 曽我部周, 石原学, 山口泉, 山本雄貴, 黒田一駿, 髙木康志 : 当院での急性期脳底動脈閉塞に対する血管内治療成績, 第48回日本脳卒中学会学術集会, 2023年3月.
3.	兼松康久, 山口泉, 石原学, 曽我部周, 宮本健志, 高麗雅章, 島田健司, 黒田一駿, 山本伸昭, 山本雄貴, 和泉唯信, 髙木康志 : 徳島県循環器病推進計画の中での急性期脳卒中診療の取り組み, STROKE2023, 2023年3月.
4.	秋本雄祐, 板東夏生, 佐藤功志, 佐藤裕紀, 百田和貴, 石原学, 上野義豊, 田根なつ紀, 板垣大雅, 大藤純 : 予定開頭手術後の橋中心髄鞘崩壊症が原因と考えられた成人喉頭軟化症の一症例．, 第50回日本集中治療医学会学術集会, 2023年3月.
5.	板東夏生, 上野義豊, 百田和貴, 佐藤功志, 佐藤裕紀, 秋本雄祐, 石原学, 田根なつ紀, 板垣大雅, 大藤純 : 電気インピーダンス・トモグラフィにて閉塞性無気肺を疑い，早期介入に至った重症COVID-19症例．, 第50回日本集中治療医学会学術集会, 2023年3月.
6.	佐藤裕紀, 板東夏生, 百田和貴, 佐藤功志, 佐藤裕紀, 秋本雄祐, 石原学, 田根なつ紀, 板垣大雅, 大藤純 : 開心術周術期の出血量や輸血量が術後再開胸止血術の頻度に与える影響．, 第50回日本集中治療医学会学術集会, 2023年3月.
7.	上野義豊, 百田和貴, 佐藤功志, 佐藤裕紀, 秋本雄祐, 布村俊幸, 石原学, 田根なつ紀, 板垣大雅, 大藤純 : 末期肺気腫に対する片肺移植後の急性拒絶反応に対し，分離肺換気が奏功した一症例, 第50回日本集中治療医学会学術集会, 2023年3月.
8.	上野義豊, 佐藤裕紀, 百田和貴, 佐藤功志, 秋本雄祐, 布村俊幸, 石原学, 田根なつ紀, 板垣大雅, 大藤純 : 開心術後患者における乳酸値ピークアウトまでの時間と術後経過との関連, 第50回日本集中治療医学会学術集会, 2023年3月.
9.	佐藤功志, 上野義豊, 佐藤裕紀, 百田和貴, 秋本雄祐, 布村俊幸, 石原学, 田根なつ紀, 板垣大雅, 大藤純 : VA-ECMO, 第50回日本集中治療医学会学術集会, 2023年3月.
10.	山口泉, 兼松康久, 溝渕佳史, 多田恵曜, 宮本健志, 曽我部周, 石原学, 鹿草宏, 山本陽子, 松田拓, 北里慶子, 髙木康志 : 硬膜転移が慢性硬膜下血腫の転帰に及ぼす影響についての後視的検討, 第46回日本脳神経外傷学会, 2023年2月.
11.	板東夏生, 宮本憲哉, 百田和貴, 佐藤功志, 佐藤裕紀, 秋本雄祐, 布村俊幸, 石原学, 上野義豊, 田根なつ紀, 板垣大雅, 大藤純 : セツキシマブ投与後のインフュージョンリアクションから心停止に至るも後遺症なく救命できた一症例, 第6回徳島外科学会, 2023年2月.
12.	高麗雅章, 兼松康久, 島田健司, 山本伸昭, 曽我部周, 石原学, 山口泉, 山本雄貴, 黒田一駿, 髙木康志 : 当院での急性期脳底動脈閉塞に対する血管内治療成績, 第38回NPO法人日本脳神経血管内治療学会学術集会, 2022年11月.
13.	秋本雄祐, 板東夏生, 佐藤功志, 佐藤裕紀, 百田和貴, 石原学, 上野義豊, 田根なつ紀, 板垣大雅, 大藤純 : くも膜下出血後のたこつぼ心筋症および神経原性肺水腫に対してバゾプレシンを用いて循環管理を行った1例．, 第50回日本救急医学会総会・学術集会, 2022年10月.
14.	百田和貴, 板東夏生, 佐藤功志, 佐藤裕紀, 秋本雄祐, 布村俊幸, 石原学, 上野義豊, 田根なつ紀, 板垣大雅, 大藤純 : 重篤な循環不全を呈した重症レジオネラ肺炎に対しVA-ECMO導入により救命した1例．, 第50回日本救急医学会総会・学術集会, 2022年10月.
15.	兼松康久, 山口泉, 石原学, 曽我部周, 高麗雅章, 多田恵曜, 島田健司, 黒田一駿, 山本雄貴, 山本伸昭, 佐藤健太, 島谷佳光, 亘雄也, 田村哲也, 新野清人, 髙木康志 : 徳島県総合メディカルゾーンでの急性期脳卒中診療の取り組み, 日本脳神経外科学会第81回学術総会, 2022年9月.
16.	兼松康久, 山口泉, 石原学, 曽我部周, 宮本健志, 高麗雅章, 島田健司, 黒田一駿, 山本雄貴, 山本伸昭, 和泉唯信, 髙木康志 : 徳島県循環器病推進計画の中での急性期脳卒中診療の取り組み, 徳島医学会学術集会, 2022年7月.
17.	石原学, 黒田一駿, 山本雄貴, 上野義豊, 田根なつ紀, 綱野祐美子, 板垣大雅, 高木康志, 大藤純 : 重症COVID-19感染後に発症した，脳葉型出血の1例．, 第49回日本集中治療医学会学術集会, 2022年3月.
18.	山口泉, 兼松康久, 島田健司, 山本伸昭, 曽我部周, 宮本健志, 石原学, 山本雄貴, 髙木康志 : 開頭下にLabbe静脈を直線穿刺することで治療し得たTSS d-AVFの1例, 近畿脳神経血管内手術法ワークショップ, 2022年1月.
19.	山口泉, 兼松康久, 島田健司, 山本伸昭, 曽我部周, 宮本健志, 石原学, 山本雄貴, 髙木康志 : 開頭下にLabbe静脈の直線穿刺によるTVEを行ったTSS d-AVFの1例, 第92回日本脳神経外科学会中国四国支部会, 2021年12月.
20.	宮本健志, 曽我部周, 兼松康久, 四方英二, 山口泉, 石原学, 島田健司, 山本雄貴, 山本伸昭, 和泉唯信, 髙木康志 : 脳主幹動脈閉塞に対して急性期再開通療法後MRIのRibbon signの特徴, 日本脳神経血管内治療学会, 2021年11月.
21.	上野義豊, 秋本雄祐, 中野勇希, 石原学, 佐藤功志, 佐藤裕紀, 百田和貴, 田根なつ紀, 綱野祐美子, 板垣大雅, 大藤純 : 重症COVID-19患者の転院および救急搬送における問題点の検討．, 第49回日本救急医学会総会・学術集会, 2021年11月.
22.	中野勇希, 佐藤功志, 佐藤裕紀, 百田和貴, 秋本雄祐, 上野義豊, 石原学, 田根なつ紀, 綱野祐美子, 板垣大雅, 大藤純 : 腹部コンパートメント症候群による呼吸不全をきたした小児神経芽腫Stage 4Sの一症例．, 第49回日本救急医学会総会・学術集会, 2021年11月.
23.	上野義豊, 秋本雄祐, 中野勇希, 石原学, 荒瀬美晴, 百田和貴, 佐藤功志, 佐藤裕紀, 田根なつ紀, 綱野祐美子, 板垣大雅, 大藤純 : 重症COVID-19患者の転院および救急搬送における問題点の検討．, 第1回南四国・集中治療医学フォーラム, 2021年11月.
24.	石原学, 兼松康久, 中西信人, 森垣龍馬, 山本伸昭, 大藤純, 獅々堀正幹, 髙木康志 : 日本ICU患者データベース(JIPAD)による急性期脳卒中症例の検討機械学習(データマイニング)を用いた解析, 日本脳神経外科学会学術総会, 2021年10月.
25.	兼松康久, 金澤裕樹, 島田健司, 曽我部周, 宮本健志, 石原学, 四方英二, 山口泉, 多田恵曜, 山本雄貴, 山本伸昭, 原田雅史, 髙木康志 : CEST MRIを用いた頚動脈プラーク診断 Chemical exchange saturation transfer MRI for carotid plaque imaging, NMC Case Report Journal, 2021年10月.
26.	宮本健志, 山口泉, 四方英二, 石原学, 曽我部周, 島田健司, 兼松康久, 髙木康志 : 閉塞性血管障害に対する血行再建術後におけるArterial spin-labelingの変化, NMC Case Report Journal, 2021年10月.
27.	山口泉, 兼松康久, 島田健司, 山本伸昭, 宮本健志, 曽我部周, 石原学, 山本雄貴, 髙木康志 : 硬膜動静脈瘻の診断におけるArterial spin-labelingの有用性の検討 Usefulness of Arterial Spin-Labeling for diagnosis of dural arteriovenous fistulae, 日本脳神経外科学会第80回学術総会, 2021年10月.
28.	板垣大雅, 秋本雄祐, 中野勇希, 上野義豊, 石原学, 田根なつ紀, 綱野祐美子, 大藤純 : 人工呼吸開始後早期のdouble cyclingが横隔膜厚の変化に与える影響．, 第43回日本呼吸療法医学会学術集会, 2021年7月.
29.	兼松康久, 島田健司, 曽我部周, 宮本健志, 石原学, 山口泉, 山本雄貴, 山本伸昭, 髙木康志 : 当施設における巨大血栓化脳動脈瘤に対する治療成績, 第46回日本脳卒中学会学術集会, 2021年3月.
30.	石原学, 中西信人, 兼松康久, 森垣龍馬, 山本伸昭, 髙木康志, 大藤純 : 日本ICU患者データベース(JIPAD)による急性期脳卒中症例の検討, 日本集中治療医学会雑誌, 2021年2月.
31.	髙島拓也, 上野義豊, 石原学, 中西信人, 田根なつ紀, 綱野祐美子, 板垣大雅, 大藤純 : 目標換気量の表示が人工呼吸患者の低一回換気量/肺保護換気の順守率に与える影響, 日本集中治療医学会雑誌, 2021年2月.
32.	秋本雄祐, 中西信人, 中野勇気, 髙島拓也, 上野義豊, 田根なつ紀, 綱野祐美子, 石原学, 板垣大雅, 大藤純 : 本邦ICUにおける心臓血管外科術後患者の疫学調査 -JIPADデータ解析-(優秀演題), 日本集中治療医学会雑誌, 2021年2月.
33.	中西信人, 大藤純, 秋本雄祐, 中野勇気, 髙島拓也, 石原学, 中瀧恵実子, 西村匡司 : ワークショップ13「上下肢筋萎縮は院内死亡・身体機能障害と関連する」, 日本集中治療医学会雑誌, 2021年2月.
34.	石原学, 竹村星哉, 兼松康久, 森垣龍馬, 山本伸昭, 大藤純, 大野将樹, 獅々堀正幹, 髙木康志 : 機械的学習を用いた医療データの解析脳出血症例の検討, 第79回日本脳神経外科学会学術総会, 2020年10月.
35.	柿原紋太, 野崎夏江, 兼本ひろみ, 津田恵, 山本恭代, 山本雄貴, 山本伸昭, 石原学, 島田健司, 兼松康久, 西京子, 加藤真介, 髙木康志 : 徳島大学病院脳卒中センター(SCU)における排尿ケアチーム介入後の下部尿路機能障害の現状, 第45回日本脳卒中学会総会(web開催), 2020年8月.
36.	秋本雄祐, 上野義豊, 髙島拓也, 石原学, 中西信人, 田根なつ紀, 綱野祐美子, 板垣大雅, 大藤純 : 側弯矯正固定術後の急性換気不全に対し気管支鏡による選択的気管支拡張術が奏功した1例, 日本集中治療医学会第4回中国・四国支部学術集会, 2020年7月.
37.	山本雄貴, 山本伸昭, 兼松康久, 石原学, 宮本健志, 高麗雅章, 島田健司, 牟礼英生, 髙木康志, 和泉唯信 : 転倒後の脳脊髄液減少症に上矢状静脈洞血栓症を合併し, 血管内治療をおこなった一例, 第35回日本脳神経血管内治療学会学術総会, 2019年11月.
38.	石原学, 兼松康久, 山本伸昭, 宮本健志, 高麗雅章, 島田健司, 山本雄貴, 大藤純, 髙木康志 : NIHSS 5点以下の軽症脳主幹動脈閉塞症例における予後因子, 日本脳神経外科学会第78回学術集会, 2019年10月.
39.	石原学, 髙島拓也, 上野義豊, 中西信人, 田根なつ紀, 綱野祐美子, 板垣大雅, 大藤純 : NIHSS5点以下の軽症脳主幹動脈閉塞症例の予後因子, 第47回日本救急医学会総会, 2019年10月.
40.	山本伸昭, 山本雄貴, 石原学, 宮本健志, 島田健司, 兼松康久, 和泉唯信, 髙木康志 : 血行再建術前における経静脈的造影剤投与によるFlat panel CTAの有用性, 中四国脳卒中研究会, 2019年9月.
41.	山本伸昭, 黒田一駿, 山本雄貴, 石原学, 高麗雅章, 島田健司, 兼松康久, 和泉唯信, 髙木康志 : Tandem Occlusion患者に対する血管内治療(Simultaneous Approach), 第44回日本脳卒中学会学術集会, 2019年3月.
42.	山本雄貴, 山本伸昭, 黒田一駿, 福本竜也, 石原学, 高麗雅章, 島田健司, 兼松康久, 和泉唯信, 髙木康志 : 治療後に症状増悪した上矢状静脈洞血栓症の一例, 第8回脳血管内治療四国遍路塾, 2019年3月.

助教 : 石原学

研究活動

専門分野

研究テーマ

著書・論文

学術論文(審査論文):

学術論文(紀要・その他):

国際会議:

国内講演発表:

助教 : 石原 学

研究活動

専門分野

研究テーマ

著書・論文

学術論文(審査論文):

学術論文(紀要・その他):

国際会議:

国内講演発表:

助教 : 石原学